EmbryoScope

CRGW were the first clinic in Wales and the South West, and amongst the first clinics in the UK to offer a revolutionary new technique called 'EmbryoScope Imaging'. This equipment records images of embryos every 15 minutes. Embryos are programmed to divide at set time intervals and the timing of these divisions has been shown to be of high clinical value to optimise IVF outcomes. Time lapse videos of your embryos will enable our embryologists to enhance embryo selection for transfer by studying these timelines of cell division. This novel and unique application has shown to have a vast improvement in pregnancy rates as patterns of embryo development can be monitored to select the most viable embryos from a group. Recent reports emerging about the use of this technology is very promising and can also be used to reduce the number of embryos to transfer in order to minimise the risks of multiple pregnancy.

What makes EmbryoScope Unique?

Embryoscope is the only time lapse embryo incubator that maintains your embryos in an environment that never changes. Non-EmbryoScope time lapse incubators allow your embryos to be exposed to a changing environment since they require the incubator door to be opened several times a day exposing your embryos to changes in temperature and pH both of which can have a negative effect on the way your embryos grow. Patients seeking the benefits of time lapse imaging for their embryos should insist on the best imaging incubator – EmbryoScope.

EmbryoScope: The science

Which embryos have the best opportunity to develop into a viable pregnancy? A new technology provides a surprising answer.
A major challenge in the field of IVF is selecting the single best embryo which is likely to result in a live birth. Currently, embryologists must remove the embryo from a standard incubator to perform 2 or 3 short evaluations of the developing embryo under the microscope, at fixed time-points over 3-5 days, in order to assess embryo quality prior to transferring an embryo to the patient.
The EmbryoScope Time-lapse system generates a movie allowing embryologists to monitor various characteristics of the embryo development over the entire incubation period, while maintaining optimum incubation conditions in a state-of-the-art incubator.
According to breakthrough scientific results, embryos which exhibit irregular division patterns have a much lower pregnancy potential. The results were made available online on August 27 2012 in the journal Fertility & Sterility, and confirms the benefits of implementing the EmbryoScope Time-lapse system.
A clinical multi-centre study of 5225 embryos, reports significantly reduced implantation of embryos which have a second division cycle (when an embryos splits from 2 to 4 cells) occurring in less than 5 hours compared to the implantation probability of "normally" developing embryos. The embryos with a short second division cycle will simply not have enough time for ‘DNA replication’, which is a prerequisite for a normal cell division.
Nearly 14% of all examined embryos exhibited this division pattern and according to the study will have a greatly reduced probability of resulting in a viable pregnancy. For both patients and fertility clinics it is important to decrease transfer of embryos with low very low implantation potential. With this new technology, clinics now have objective criteria with which to identify the embryo with a higher chance of implanting allowing more successful single embryo transfer cycles. Marcos Meseguer, co-author of the paper and senior embryologist at Equipo IVI in Valencia, states "The ability to identify abnormal development events in embryos is certainly a key advantage of using time-lapse systems such as the EmbryoScope allowing us to improve our patient treatment".
The improvement potential of implementing time-lapse systems is increasing constantly as embryologists discover new information about early human embryo development.

MORE INFORMATION?
If you have specific questions about EmbryoScope or how CRGW can help you please email us or telephone the clinic to speak to a member of the team on 01443 443999.

What is EmbryoScope?

The Embryoscope is an advanced incubator which allows the embryo to be observed minute by minute from the point when in vitro fertilisation takes place to the moment when it is transferred into the uterus. This brand new technique, based on the conventional incubators used in clinical embryology laboratories, includes an image capture system which allows an enormous amount of specific and objective information to be obtained for every embryo, which up until now could not be recorded. This allows us to find out new information about the embryos in a non-invasive way, as it avoids the need for taking the embryo out of the incubator to assess its development, improving the selection criteria and, as a result, pregnancy rates.

What does embryo selection involve?

Traditionally, approximations for identifying the best embryos prior to transfer were essentially based on a morphological evaluation; obviously, these observations provided indications which supported the skill of the embryologist when it came to selecting an embryo for transfer. The definition of what represents a "perfect embryo" and the choice of those with the best potential for implantation are still very imprecise concepts, and the ability (or lack of ability) to estimate embryo competence correctly has become a critical point of the process. As a result, the selection options and strategies used will depend on all of the information that we can find out about the embryo. The morphological and growth criteria which are currently used for evaluating embryo viability on day 3 either underestimate or overestimate their potential for development. In light of the uncertainty associated with the morphological examination on day 3, some reproduction centres have opted for a longer cultivation period for evaluating embryo competence. While the morphological examination method has the advantage of being simple, non-invasive and quick, it has the disadvantage of being highly subjective and requiring specialised training and a certain degree of experience, and there is little hope for its standardisation.
With the EmbryoScope we can carry out a study of the kinetics of development. The relationship between the speed of cell division and embryo competence is becoming a valid alternative for selecting the embryos which have the best potential for implantation. We know that the time which elapses between fertilisation and the first cell division is a parameter which is objective and easy to determine, and that it has a predictive value in terms of embryo viability.
This image analysis system provides us with a series of benefits, one of which is knowing exactly when cell divisions occur. Using this information we have been able to learn that there are optimum division periods in which embryos have more than a 20% probability of implanting, as shown in the following graph.

Advantages of the EmbryoScope in relation to standard incubators

The EmbryoScope represents a technological revolution in the field of embryology. It allows us to carry out a more personalised evaluation of the embryo in real time, and to know which is the best embryo for transfer, and when. Continuous image capture for every embryo is recorded as a video, allowing embryos to be monitored fully and obtaining all of the details which emerge during their development. The advantages compared to other incubators are as follows:

1. EmbryoScope improves embryo selectionThis image analysis system provides us with a series of benefits, one of which is knowing exactly when cell divisions occur. Using this information we have been able to learn that there are optimum division periods in which embryos have more than a 20% probability of implanting, as shown in the following graph. Time-lapse technology provides embryologists with a much more powerful decision-making system, which is based on the actual condition of the embryo and on the process of embryo development.2.EmbryoScope improves embryo culture and manipulation conditionsThe possibility of making observations using time-lapse has been around for decades; however, technical, financial and conceptual complications have hindered its use. The new generation of systems which combine an incubator and a microscope offer the chance to describe the morphological characteristics of embryos without the need for removing them from the optimum gas and temperature conditions found inside the incubator. This reduces the environmental stress experienced by the embryo, which results in improved embryo competence and higher pregnancy rates. 3. EmbryoScope gives parents-to-be more information about the embryoThe incorporation of image analysis technology enables us not only to establish the duration of cell divisions but also to confirm the critical observations made previously.
It is important to point out that in this type of incubator the embryos are periodically exposed to light, at the point when the digital images are taken. This exposure of the embryo to light creates an additional stress factor which can affect embryo development. In spite of the risks that this involves, the embryos are exposed to LED-type light for less than 50 seconds per day, which explains the lack of significant differences in the results of the parameters evaluated between embryos which are cultivated in a time-lapse system and embryos which are subjected to periodic observations in a conventional incubator. 4. EmbryoScope provides a record on film of the beginning of the future baby's life It provides a record in pictures and videos of the very beginning of your future baby's life. This pioneering technique allows embryo cell division to be viewed on a monitor in real time, capturing moments from the beginning of life.

It increase the chances of becoming pregnant

This technology eliminates the need for removing the embryo from the incubator, which increases the chances of pregnancy as there is no need to handle the embryo. Published medical evidence shows that culturing and selecting embryos in EmbryoScope significantly improves the probability of clinical pregnancy by 20.1% per oocyte retrieval and 15.7% per embryo transfer. To see the published medical paper please click here.

Which patient can use the EmbryoScope?

In theory this technology can be applied to any type of patient undergoing an assisted reproduction treatment, although the chances of an improvement in the results are greatest among patients who generate more embryos because there is a better possibility for selection. At CRGW from March 1st 2014 all patients embryos are cultured in one of our EmbryoScopes.

How much does EmbryoScope cost?

Typically the use of the EmbryoScope in UK clinics is £700-£850 on top of the cost of an IVF/ICSI cycle for up to a maximum of 12 embryos.
At CRGW where we put patients before profit there is no additional cost to EmbryoScope time-lapse culture. In early 2014 only 2 clinics in the whole of the UK offer 100% EmbryoScope time-lapse culture without charging additionally for its use.